An approach to the analysis of health care needs and resources

A semi-quantitative method of analysing the relationship between health care resources and need is described. It utilises the Donabedian model which expresses needs and resources in equivalent units in order to estimate the ratio of resources to need. The optimum resource/need ratio is regarded as that pertaining to the reference population; deviation from this optimum ratio in the subunits of the reference population is interpreted as a manifestation of inequitable resource distribution. An example is presented of the application of the method to the Greater Glasgow Health Board and its five constituent districts for the years 1974-77. It is argued that this method might, without undermining the principle of geographical equity, meet some of the objections to the more rigid 'formula' approach in the report of the Resource Allocation Working Party (RAWP) and in the Scottish Health Authorities Revenue Equalisation (SHARE) report.